Internal fixation of undisplaced femoral neck fractures in the elderly

A retrospective comparison of fixation methods

Yih Shiunn Lee, Shih Hao Chen, Yang Hwei Tsuang, Hui Ling Huang, Ting Ying Lo, Chien Rae Huang

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

BACKGROUND: There has been no report related to comparison of fixation methods using minimally invasive dynamic hip screw (MIDHS), conventional dynamic hip screw (CDHS), and multiple cannulated screws (MCS) for treating the undisplaced femoral neck fractures. METHODS: The study retrospectively evaluates the comparison of fixation methods. Ninety elderly patients (>60 years) with the undisplaced intracapsular femoral neck fractures were treated with osteosynthesis by either dynamic hip screw (DHS) or MCS. The patient distribution was regarded as randomized. A new minimally invasive technique of DHS (MIDHS) was presented. Pauwels' classification was used to evaluate the fracture verticality. Singh index was used to evaluate the bone quality. All patients were followed up retrospectively for at least 12 months to compare the clinical results among the MIDHS, CDHS, and MCS groups. RESULTS: Pauwels types and Singh index were similar among the three groups (all p values ≥0.78). The CDHS group had significantly larger wound incision, greater hemoglobin level drop, and longer hospital stay than either the MIDHS or MCS groups (all p values ≤0.014). Differences in hip score, incision length, surgery time, hemoglobin level drop, and hospital stay between the MIDHS and MCS groups were not significant (all p values ≥0.28). The MIDHS group showed a trend of an increased rate of overall success compared with the MCS group, although this was not statistically significant (97% vs. 84.4%, p = 0.11). CONCLUSION: CDHS had more disadvantages related to more soft tissue stripping than either MIDHS or MCS. MIDHS showed a trend of an increased rate of overall success in an elderly patient with undisplaced femoral neck fracture when compared with MCS.

Original languageEnglish
Pages (from-to)155-162
Number of pages8
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume64
Issue number1
DOIs
Publication statusPublished - Jan 2008
Externally publishedYes

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Femoral Neck Fractures
Hip
Length of Stay
Hemoglobins
Operative Time

Keywords

  • Cannulated screw
  • Conventional DHS
  • Femoral neck fracture
  • Minimally invasive DHS
  • Pauwels type
  • Singh index

ASJC Scopus subject areas

  • Surgery

Cite this

Internal fixation of undisplaced femoral neck fractures in the elderly : A retrospective comparison of fixation methods. / Lee, Yih Shiunn; Chen, Shih Hao; Tsuang, Yang Hwei; Huang, Hui Ling; Lo, Ting Ying; Huang, Chien Rae.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 64, No. 1, 01.2008, p. 155-162.

Research output: Contribution to journalArticle

Lee, Yih Shiunn ; Chen, Shih Hao ; Tsuang, Yang Hwei ; Huang, Hui Ling ; Lo, Ting Ying ; Huang, Chien Rae. / Internal fixation of undisplaced femoral neck fractures in the elderly : A retrospective comparison of fixation methods. In: Journal of Trauma - Injury, Infection and Critical Care. 2008 ; Vol. 64, No. 1. pp. 155-162.
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abstract = "BACKGROUND: There has been no report related to comparison of fixation methods using minimally invasive dynamic hip screw (MIDHS), conventional dynamic hip screw (CDHS), and multiple cannulated screws (MCS) for treating the undisplaced femoral neck fractures. METHODS: The study retrospectively evaluates the comparison of fixation methods. Ninety elderly patients (>60 years) with the undisplaced intracapsular femoral neck fractures were treated with osteosynthesis by either dynamic hip screw (DHS) or MCS. The patient distribution was regarded as randomized. A new minimally invasive technique of DHS (MIDHS) was presented. Pauwels' classification was used to evaluate the fracture verticality. Singh index was used to evaluate the bone quality. All patients were followed up retrospectively for at least 12 months to compare the clinical results among the MIDHS, CDHS, and MCS groups. RESULTS: Pauwels types and Singh index were similar among the three groups (all p values ≥0.78). The CDHS group had significantly larger wound incision, greater hemoglobin level drop, and longer hospital stay than either the MIDHS or MCS groups (all p values ≤0.014). Differences in hip score, incision length, surgery time, hemoglobin level drop, and hospital stay between the MIDHS and MCS groups were not significant (all p values ≥0.28). The MIDHS group showed a trend of an increased rate of overall success compared with the MCS group, although this was not statistically significant (97{\%} vs. 84.4{\%}, p = 0.11). CONCLUSION: CDHS had more disadvantages related to more soft tissue stripping than either MIDHS or MCS. MIDHS showed a trend of an increased rate of overall success in an elderly patient with undisplaced femoral neck fracture when compared with MCS.",
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N2 - BACKGROUND: There has been no report related to comparison of fixation methods using minimally invasive dynamic hip screw (MIDHS), conventional dynamic hip screw (CDHS), and multiple cannulated screws (MCS) for treating the undisplaced femoral neck fractures. METHODS: The study retrospectively evaluates the comparison of fixation methods. Ninety elderly patients (>60 years) with the undisplaced intracapsular femoral neck fractures were treated with osteosynthesis by either dynamic hip screw (DHS) or MCS. The patient distribution was regarded as randomized. A new minimally invasive technique of DHS (MIDHS) was presented. Pauwels' classification was used to evaluate the fracture verticality. Singh index was used to evaluate the bone quality. All patients were followed up retrospectively for at least 12 months to compare the clinical results among the MIDHS, CDHS, and MCS groups. RESULTS: Pauwels types and Singh index were similar among the three groups (all p values ≥0.78). The CDHS group had significantly larger wound incision, greater hemoglobin level drop, and longer hospital stay than either the MIDHS or MCS groups (all p values ≤0.014). Differences in hip score, incision length, surgery time, hemoglobin level drop, and hospital stay between the MIDHS and MCS groups were not significant (all p values ≥0.28). The MIDHS group showed a trend of an increased rate of overall success compared with the MCS group, although this was not statistically significant (97% vs. 84.4%, p = 0.11). CONCLUSION: CDHS had more disadvantages related to more soft tissue stripping than either MIDHS or MCS. MIDHS showed a trend of an increased rate of overall success in an elderly patient with undisplaced femoral neck fracture when compared with MCS.

AB - BACKGROUND: There has been no report related to comparison of fixation methods using minimally invasive dynamic hip screw (MIDHS), conventional dynamic hip screw (CDHS), and multiple cannulated screws (MCS) for treating the undisplaced femoral neck fractures. METHODS: The study retrospectively evaluates the comparison of fixation methods. Ninety elderly patients (>60 years) with the undisplaced intracapsular femoral neck fractures were treated with osteosynthesis by either dynamic hip screw (DHS) or MCS. The patient distribution was regarded as randomized. A new minimally invasive technique of DHS (MIDHS) was presented. Pauwels' classification was used to evaluate the fracture verticality. Singh index was used to evaluate the bone quality. All patients were followed up retrospectively for at least 12 months to compare the clinical results among the MIDHS, CDHS, and MCS groups. RESULTS: Pauwels types and Singh index were similar among the three groups (all p values ≥0.78). The CDHS group had significantly larger wound incision, greater hemoglobin level drop, and longer hospital stay than either the MIDHS or MCS groups (all p values ≤0.014). Differences in hip score, incision length, surgery time, hemoglobin level drop, and hospital stay between the MIDHS and MCS groups were not significant (all p values ≥0.28). The MIDHS group showed a trend of an increased rate of overall success compared with the MCS group, although this was not statistically significant (97% vs. 84.4%, p = 0.11). CONCLUSION: CDHS had more disadvantages related to more soft tissue stripping than either MIDHS or MCS. MIDHS showed a trend of an increased rate of overall success in an elderly patient with undisplaced femoral neck fracture when compared with MCS.

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KW - Pauwels type

KW - Singh index

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